De-Implementation of Low-value Testing in Patients Undergoing Low-Risk Surgery
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18+
SponsorUniversity of Michigan
About this trial
This trial aims to evaluate the effectiveness of a multi-level, multi-component de-implementation strategy to reduce unnecessary preoperative testing. Sixteen Michigan Value Collaborative (MVC)/Michigan Surgical Quality Collaborative (MSQC) sites in Michigan will implement several tools that have been proven to reduce unnecessary testing at a single site, including clinician education, a decision aid, audit and feedback on performance, and a pay-for-performance incentive. The researchers believe that, through the use of these strategies, there will be a significant reduction in unnecessary preoperative testing during the intervention.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Over 30% of testing rates on at least one of the three index procedures (breast lumpectomy, laparoscopic cholecystectomy, and inguinal hernia repair)
Disqualifiers
none
Trial design
Design model
Sequential
Treatments tested in this trial
Active de-Implementation
BehavioralDuring active de-implementation (3 months), the local team will distribute the strategy components (i.e., clinician education, decision support, evaluation, consensus building around perioperative testing pathways, facility-specific feedback, and a pay-for-performance incentive) at the local site.
Treatment groups
16 Participants
are divided into 6 treatment groups6
Treatment groupsSee each treatment group below.
Group A: Wave 1Experimental treatment 1 intervention
Group B: Wave 2Experimental treatment 1 intervention
Group C: Wave 3Experimental treatment 1 intervention
Group D: Wave 4Experimental treatment 1 intervention
Group E: Wave 5Experimental treatment 1 intervention
Group F: Wave 6Experimental treatment 1 intervention
Trial outcomes
Primary outcomes
1
Number of tests within 30 days of surgery not associated with an emergency department visit
Only tests relating to three index procedures; breast lumpectomy, laparoscopic cholecystectomy, and inguinal hernia repair Data collected using MVC/MSQC database
Time frame
Within 30 days of surgerySecondary outcomes
1
Number of unnecessary preoperative testing before low-risk surgery at MVC/MSQC sites not participating in the trial
Example related operations: laparoscopic hysterectomy, knee arthroscopy
Time frame
Up to year 2, quarter 42
30-day episode-based spending
Using the MVC claims data for total spending amounts
Time frame
Up to Year 2, Quarter 23
Number of unnecessary preoperative testing before low-risk surgery at trial sites
Example related operations: laparoscopic hysterectomy, knee arthroscopy
Time frame
Up to year 2, quarter 44
Number of intraoperative complications
Examples: myocardial infarction, stroke
Time frame
Up to year 2, quarter 4Sponsors and contacts
Click on the lead sponsor to view all of their trials.
University of Michigan
Lead sponsor
Agency for Healthcare Research and Quality (AHRQ)
Collaborator
Blue Cross Blue Shield of Michigan Foundation
Collaborator
Source ClinicalTrials.gov